Suicide Prevention

Helena High students pass through a hallway with a reminder about The National Hopeline Network suicide hotline depicted in a student's artwork. Montana (counting both teens and adults) had the highest suicide rate in the country in 2014, the most recent year for which national data is available.

Thom Bridge, Independent Record

“I never really understood how people could truly be heartbroken,” said Aaron Fossedal, a recent Helena High School graduate. “I never understood that.”

But that changed the day he learned that his brother had committed suicide.

“My heart literally had pain,” Fossedal said. “It’s something you think will never happen to you -- especially since he was a Marine. Just like the movies -- two Marines come to your door, letting you know your brother passed away. It was Aug. 23, 2015.”

“I was very zombie-ized.”

It didn’t hit until the first day of school, “when I broke down and cried.”

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Aaron Fossedal

“My heart literally had pain,” Aaron Fossedal said. “It’s something you think will never happen to you -- especially since he was a Marine. Just like the movies -- two Marines come to your door, letting you know your brother passed away. It was Aug. 23, 2015.”

Last fall, Fossedal and his friend, Rowan Rankin, threw themselves into suicide prevention efforts at HHS.

They started a Facebook page for Saving HHS, getting 1,000 likes in the first 24 hours alone. The number had climbed to over 2,500 by this summer.

They gave out hundreds of teal- and- purple-colored bracelets with the message "Saving HHS," printed with the national suicide prevention hotline number (1-800-273-8255 or 1-800-273-TALK).

But in February, more heartbreak struck.

A Helena High student died by suicide, the fifth student at HHS in four years -- leaving family, friends and staff devastated.

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Matt Kuntz

NAMI Montana Executive Director Matt Kuntz 

Matt Kuntz, executive director of the National Alliance on Mental Illness, Montana, went into the school to meet with some of the students, including Fossedal.

“Mental health ... is just as important as physical illness,” Fossedal told Kuntz. “It needs to be treated.”

He and other students asked for hands-on tools and skills to aid in suicide prevention.

The school district responded.

This fall, Helena Public Schools is launching a new and innovative suicide prevention program, YAM (Youth Aware of Mental Health) that aims to fit that need. YAM has already proven highly effective with youth in Europe.

A public meeting announcing the program is set for 5:30 to 7:30 p.m. Monday, Sept. 19, at Helena Middle School auditorium.

Both HHS and Capital High School will be part of a pilot project in Montana and Texas directed by Dr. Matt Byerly, a psychiatrist and director for the Center for Mental Health Research and Recovery at Montana State University in Bozeman. NAMI Montana and Kuntz were instrumental in bringing the research center and YAM to Montana.

Suicide is not just a major concern at Helena High School, it’s a leading public health issue -- particularly in Montana.

Butte has had at least five teen suicides in recent years; Livingston had two within one week in February; and Bozeman recently had one.

Montana (counting both teens and adults) had the highest suicide rate in the country in 2014, the most recent year national data is available.

And Montana has the dubious distinction of being in the top five states for suicide rates for nearly 40 years.

Youth Aware of Mental Health

Researchers in the European Union in 2009 collaborated on developing a suicide prevention mental health program for youth across the European Union, said Byerly. “YAM (which is modeled on the European program) was designed from the beginning to be cross-cultural.”

In a study that included 11,000 freshmen students from 10 countries across the European Union, researchers reported that students in the program had a 59 percent reduction in suicide attempts and a 52 percent reduction in suicidal thoughts compared to students in a control group, said Byerly.

These were youth who had not previously had suicide attempts, he emphasized. Those youth who have already attempted suicide would “need intensive mental health treatments,” not YAM.

YAM is a “primary prevention intervention,” he said, meaning that it is meant to prevent an initial suicide attempt from happening.

In the 2009 study, YAM proved much more successful than any other suicide prevention programs and interventions, according to the research published in the medical journal Lancet in 2015.

What YAM does

It uses trained facilitators, not school personnel, to work with the youths, said Byerly. All of the facilitators that will be working in the Helena schools have extensive experience working with youth around mental health topics.

YAM promotes adolescents talking with each other about mental health issues and also learning hands-on skills in role-playing how to cope with crises.

“Youth are active in this intervention,” Byerly said. “They’re challenged to think in different ways and tackle things they perhaps have not thought about. They’re the ones who are actively doing it.”

In October, groups of 25 to 30 freshmen at both HHS and Capital High School will begin the first part of their multi-week training. When that group is done, facilitators will begin working with the next set of groups. All told -- approximately 400 HHS freshman and 330 at CHS will receive the training in the coming year.

Some key YAM elements include:

  • Outside facilitators who have significant background working with youth and an assistant facilitator deliver the program 
  • Two, one-hour discussion sessions
  • A booklet on topics ranging from self-help to how to help a troubled friend
  • Six educational posters that prominently display repeat themes covered in the training
  • Three hours of role-playing so students build skills to deal with crises and stress

Some of the protective factors it teaches are skills in problem-solving, conflict resolution and nonviolent ways of handling disputes, said Byerly.

Mental health researchers are particularly impressed with how YAM’s role-playing and discussions give youth “probably for the first time an opportunity to think, verbalize and discuss ... a range of mental health related issues, especially suicidality,” said Byerly.

Role-playing details 

Each of the role-play sessions has a goal in mind. Students learn in Role Play 1 about choices they make in everyday life, Byerly said.

“The choices they make impact their lives. It’s not that life just happens to them and they have no choices.”

Youth-at-risk often don’t realize they can make a choice that would put them in a different situation, he said. They also don’t realize there is more than one solution to a problem.

In Role Play 2, students deal with stress and crisis topics, like coping with a break-up with a girlfriend or boyfriend.

The idea is that students learn how to express their emotional struggles, he said, rather than an adult telling them what to do.

Role Play 3 deals with handling tougher emotional topics, such as a youth experiencing depression or suicidal thoughts and how to obtain help.

The trained facilitators make sure the exercises remain safe, said Byerly.

The European trainers who trained the Montana facilitators noted they had one of the highest levels of engagement with youth, said Byerly, and ranked them “extremely engaging and very comfortable with youth.”

Helena high schools are among approximately 11 in Montana and three to four in Texas participating in the YAM program.

While it focuses on freshmen now, Byerly would like to expand YAM to include middle schoolers in the future.

Intervening before a suicide attempt has occurred is more effective, he said. Therefore, “the earlier we intervene the more successful we’ll be.”

Byerly urged that youth, parents and community members attend the Sept. 19 meeting to hear about the program, which he will present, and ask questions.

A large part of the program’s success will be how well it is accepted in the community, he said.

“Suicide is potentially preventable. It is such an important and tragic problem that we must find solutions that work. We need to make an investment to study and identify interventions that truly work.”

YAM is funded by a Montana Research and Economic Development Initiative grant and is being offered free to the Helena school district. 

Reporter Marga Lincoln can be reached at 447-4083 marga.lincoln@helenair.com

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